Anticipated End Date:

2024-08-26

Position Title:

Client Management Director, Payment Integrity

Job Description:

Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. 

Our Payment Integrity (PI) organization is looking to hire a Client Management Director.   This vital role will create and enhance strategic client relationships for commercial our ASO clients.  Leading the most complex client success and retention strategies for our commercial business, they will focus on several key areas: driving savings expansion through identification of new service opportunities, assisting in creating client strategic and annual plans, closely monitoring associated legislation, and providing critical compliance advisory to senior management.

Our ideal Director will use their strong negotiation, coordination, and project management skills to help us continually improve our client relationships while successfully mitigating outside competitive challenges.  This position can work in a hybrid way from any US Elevance Health corporate work location, and the internal facing title is Strategy & Program Development Director.

How you will make an impact:

• Strategize to prevent engagement of outside PI vendors, educating clients on our in-house capabilities to ensure their requirements are efficiently met.

• When necessary, negotiate the scope, cadence, and expectations with clients when engagements with outside vendors take place. Accurately manage these situations to maintain customer satisfaction and company integrity.

• Facilitate coordination with internal company partners and client's salesperson, ensuring client needs are met with our service bouquet once an engagement occurs.

• Package the coordinated outcome, tying all the aspects together, ensuring a proficient and professional wrap up of the engagement.

• Design an infrastructure for tracking engagement processes, monitoring them, and sharing progress updates to relevant stakeholders.

• Establish a robust project management infrastructure, such as utilizing SharePoint for efficient multi-team access, process handle, and information dissemination.

• Work across a matrixed environment to ensure results delivery.

• Develop proactive strategies to defend against, and prevent third-party vendors from initiating and successfully creating engagements with our clients. This strategy may involve internal team education to reduce vulnerabilities and engaging on road shows with key clients, further cementing our relationships.  This will involve a delicate balance between curious collaboration and firm boundary setting.

• Regularly monitor legislative changes in different markets. Understand the nuances that could create vulnerabilities to particular client sets for third-party cut-ins. Advise senior management to help craft informed business strategies.

• While rare, travel to worksite and other locations will be essential as necessary to ensure company vision is effectively and efficiently conveyed and implemented.

Requires a BA/BS degree in a related field and a minimum  of 10 years of related experience including 5 years of leadership experience; or any combination of education and experience, which would provide an equivalent background.

Preferred skills and experiences:

-Client management or sales executive experience for healthcare clients; commercial fully insured, ASO, and broker clients preferably.

-Expertise in healthcare payment integrity services (payment accuracy, claims data mining, coordination of benefits, complex and clinical audit, claim edits, subrogation, SUI).

-Experience with customer success and retention strategies, C-level negotiations, presentations, and influencing.  

-Innovative mindset capable of converting reactive processes into proactive strategies for the benefit of the organization and our clients.

Location: California

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Job Level:

Director Equivalent

Workshift:

Job Family:

BUS > Strategy, Planning & Execution

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.